Events such as cardiac arrest are relatively rare in in-patient mental health settings, clinicians need to be prepared to work in interprofessional emergency response teams to manage these events. Response teams are often unknown to each other and have to work in stressful circumstances, making this an ideal focus for simulation training.
Aim South London and Maudsley NHS Foundation Trust (SLaM) designed and evaluated a pilot course across five units on four sites, including a large medium-secure unit that focused on managing medical emergencies in mental health settings. The 90-minute course featured medical emergency simulation scenarios delivered in-situ, using a high fidelity mannequin.
Method The course was delivered seven times and consisted of a 10-minute introduction to the mannequin, a 35-min scenario of a medically deteriorating patient (such as chest pain and cardiac arrest), followed by a structured 45-min video-assisted debriefing by trained facilitators. Scenarios were derived from adverse events, used equipment available in the units, and consisted of real medical emergency calls.
Result Participants (n = 58) included psychiatrists, nurses (band 5–8a), support workers, and allied health professionals. Evaluation consisted of verbal feedback and evaluation forms (response rate 70%) with all questions averaging 4 or above on a 5-point Likert scale. Participants found the scenarios to be effective and to have a positive impact on their practice and wanted further simulation sessions. Participant self-evaluation of communication, team work and technical skills showed improvement after the course and 88% of respondents reported increased confidence in dealing with future medical emergencies.
Conclusion The pilot course has shown that interprofessional in-situ simulation training for managing medical emergencies in mental health settings can be an effective intervention. A Word-of-mouth recommendation from course participants has resulted in the pilot being extended further, and evaluation results show a positive impact on clinical practice.
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Issenberg SB, McGaghie WC, Petrusa ER, Gordon DL, Scalese RJ. Features and uses of high-fidelity medical simulation that lead to effective learning: a BEME systematic review. Med Teach 2005;27:10–28
- Category: Course or curriculum evaluation/innovation/integration
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